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Current Medical Imaging

Editor-in-Chief

ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

Research Article

Prevelance of Fabella: An MRI Study in The Eastern Anatolia Region of Turkey

Author(s): Huseyin Akdeniz*, Sezai Ozkan and Cihan Adanas

Volume 17, Issue 10, 2021

Published on: 04 June, 2021

Article ID: e280521193654 Pages: 5

DOI: 10.2174/1573405617666210528121352

Abstract

Background: The fabella, which is generally located in the lateral head of the gastrocnemius muscle, is a sesamoid bone that articulates with the posterior face of the lateral femoral condyle. As traditional information, the prevalence of fabella is between 10–30% in the population and is usually present in both knees.

Introduction: The objective of this study was to investigate the knee MRIs in the Eastern Anatolia Region of Turkey subjects in order to assess the prevalence of the fabella and analyse the differences between gender, age and laterality and its symmetry pattern.

Methods: This study was a retrospective study in patients older than 18 years whose knee MRIs were taken between February 2014 and February 2016. In this study, a total of 531 patients (290 females and 241 males) were included. The radiographs were examined by two orthopedic surgeons and the fabella was located. Later, an expert radiologist made the final decision and confirmed the results.

Results: The number of patients included in the study was 531. We detected os fabella in 59 (11.1%) patients. Of the 59 os fabella, 33 were in the right knee and 26 were in the left knee, 38 were female and 21 were male.

Conclusion: In this study, we investigated the age and gender differences besides the prevalence and the symmetry pattern of the fabella in the Eastern Anatolia Region of Turkey’s population. Prevalence of the fabella was found to be 11.1% which is different than previously published studies.

Keywords: Fabella, gastrocnemius, knee, MRI, prevalence, sesamoid bone.

Graphical Abstract

[1]
Dannawi Z, Khanduja V, Vemulapalli KK, Zammit J, El-Zebdeh M. Arthroscopic excision of the fabella. J Knee Surg 2007; 20(4): 299-301.
[http://dx.doi.org/10.1055/s-0030-1248063] [PMID: 17993073]
[2]
Minowa T, Murakami G, Kura H, Suzuki D, Han SH, Yamashita T. Does the fabella contribute to the reinforcement of the posterolateral corner of the knee by inducing the development of associated ligaments? J Orthop Sci 2004; 9(1): 59-65.
[http://dx.doi.org/10.1007/s00776-003-0739-2] [PMID: 14767706]
[3]
Tabira Y, Saga T, Takahashi N, Watanabe K, Nakamura M, Yamaki K. Influence of a fabella in the gastrocnemius muscle on the common fibular nerve in Japanese subjects. Clin Anat 2013; 26(7): 893-902.
[PMID: 22933414]
[4]
Kaplan EB. The fabellofibular and short lateral ligaments of the knee joint. J Bone Joint Surg Am 1961; 43-A(2): 169-79.
[http://dx.doi.org/10.2106/00004623-196143020-00002] [PMID: 13830884]
[5]
Kawashima T, Takeishi H, Yoshitomi S, Ito M, Sasaki H. Anatomical study of the fabella, fabellar complex and its clinical implications. Surg Radiol Anat 2007; 29(8): 611-6.
[http://dx.doi.org/10.1007/s00276-007-0259-4] [PMID: 17882346]
[6]
Newell RLM. Gray’s Anatomy. (39th Ed). Philadelphia, PA: Elsevier Churchill Livingstone 2005; p. 1499.
[7]
Segal A, Miller TT, Krauss ES. Fabellar snapping as a cause of knee pain after total knee replacement: assessment using dynamic sonography. AJR Am J Roentgenol 2004; 183(2): 352-4.
[http://dx.doi.org/10.2214/ajr.183.2.1830352] [PMID: 15269024]
[8]
Phukubye P, Oyedele O. The incidence and structure of the fabella in a South African cadaver sample. Clin Anat 2011; 24(1): 84-90.
[http://dx.doi.org/10.1002/ca.21049] [PMID: 20830786]
[9]
Munk PL, Althathlol A, Rashid F, Malfair D. MR features of a giant cyamella in a patient with osteoarthritis: presentation, diagnosis and discussion. Skeletal Radiol 2009; 38(1): 69, 91-92.
[http://dx.doi.org/10.1007/s00256-008-0582-9] [PMID: 18810436]
[10]
Robertson A, Jones SC, Paes R, Chakrabarty G. The fabella: a forgotten source of knee pain? Knee 2004; 11(3): 243-5.
[http://dx.doi.org/10.1016/S0968-0160(03)00103-0] [PMID: 15194103]
[11]
Duncan W, Dahm DL. Clinical anatomy of the fabella. Clin Anat 2003; 16(5): 448-9.
[http://dx.doi.org/10.1002/ca.10137] [PMID: 12903068]
[12]
Frey C, Bjorkengen A, Sartoris D, Resnick D. Knee dysfunction secondary to dislocation of the fabella. Clin Orthop Relat Res 1987; (222): 223-7.
[http://dx.doi.org/10.1097/00003086-198709000-00030] [PMID: 3621725]
[13]
Flecker H. Time of appearance and fusion of ossification centers as observed by roentgenographic methods. AJR Am J Roentgenol 1942; 47: 97-159.
[14]
Silva JG, Chagas CAA, Torres DFM, Servidio L, Vilela AC, Chagas WA. Morphological analyisis of the fabella in Brazilians. Int J Morphol 2010; 28(1): 105-10.
[http://dx.doi.org/10.4067/S0717-95022010000100015]
[15]
Weiner D, Macnab I, Turner M. The fabella syndrome. Clin Orthop Relat Res 1977; (126): 213-5.
[PMID: 598120]
[16]
Weiner DS, Macnab I. The “fabella syndrome”: an update. J Pediatr Orthop 192; 2(4): 405-8.
[17]
Tyler P, Datir A, Saifuddin A. Magnetic resonance imaging of anatomical variations in the knee. Part 1: ligamentous and musculotendinous. Skeletal Radiol 2010; 39(12): 1161-73.
[http://dx.doi.org/10.1007/s00256-009-0870-z] [PMID: 20155418]
[18]
Jin ZW, Shibata S, Abe H, Jin Y, Li XW, Murakami G. A new insight into the fabella at knee: the foetal development and evolution. Folia Morphol (Warsz) 2017; 76(1): 87-93.
[http://dx.doi.org/10.5603/FM.a2016.0048] [PMID: 27665955]
[19]
Benjamin M, Ralphs JR. Fibrocartilage in tendons and ligaments- an adaptation to compressive load. J Anat 1998; 193(Pt 4): 481-94.
[http://dx.doi.org/10.1046/j.1469-7580.1998.19340481.x] [PMID: 10029181]
[20]
Seebacher JR, Inglis AE, Marshall JL, Warren RF. The structure of the posterolateral aspect of the knee. J Bone Joint Surg Am 1982; 64(4): 536-41.
[http://dx.doi.org/10.2106/00004623-198264040-00008] [PMID: 7068696]
[21]
Raheem O, Philpott J, Ryan W, O’Brien M. Anatomical variations in the anatomy of the posterolateral corner of the knee. Knee Surg Sports Traumatol Arthrosc 2007; 15(7): 895-900.
[http://dx.doi.org/10.1007/s00167-007-0301-4] [PMID: 17641923]
[22]
Piyawinijwong S, Sirisathira N, Sricharoenvej S. The fabella, fabellofibular and short lateral ligaments: an anatomical study in Thais cadavers. Siriraj Med J 2012; 64: 15-8.
[23]
Zeng SX, Dong XL, Dang RS, et al. Anatomic study of fabella and its surrounding structures in a Chinese population. Surg Radiol Anat 2012; 34(1): 65-71.
[http://dx.doi.org/10.1007/s00276-011-0828-4] [PMID: 21626275]
[24]
Takebe K. Radiological and anatomical observation on fabella. Seikei Geka 1983; 34(10): 1163-70.
[25]
Pritchett JW. The incidence of fabellae in osteoarthrosis of the knee. J Bone Joint Surg Am 1984; 66(9): 1379-80.
[http://dx.doi.org/10.2106/00004623-198466090-00009] [PMID: 6501334]
[26]
Sarin VK, Erickson GM, Giori NJ, Bergman AG, Carter DR. Coincident development of sesamoid bones and clues to their evolution. Anat Rec 1999; 257(5): 174-80.
[http://dx.doi.org/10.1002/(SICI)1097-0185(19991015)257:5<174::AID-AR6>3.0.CO;2-O] [PMID: 10597342]
[27]
Egerci OF, Kose O, Turan A, Kilicaslan OF, Sekerci R, Keles-Celik N. Prevalence and distribution of the fabella: a radiographic study in Turkish subjects. Folia Morphol (Warsz) 2017; 76(3): 478-83.
[http://dx.doi.org/10.5603/FM.a2016.0080] [PMID: 28026849]
[28]
Chew CP, Lee KH, Koh JS, Howe TS. Incidence and radiological characteristics of fabellae in an Asian population. Singapore Med J 2014; 55(4): 198-201.
[http://dx.doi.org/10.11622/smedj.2014052] [PMID: 24763835]
[29]
Yu JS, Salonen DC, Hodler J, Haghighi P, Trudell D, Resnick D. Posterolateral aspect of the knee: improved MR imaging with a coronal oblique technique. Radiology 1996; 198(1): 199-204.
[http://dx.doi.org/10.1148/radiology.198.1.8539378] [PMID: 8539378]
[30]
Terry GC, LaPrade RF. The posterolateral aspect of the knee. Anatomy and surgical approach. Am J Sports Med 1996; 24(6): 732-9.
[http://dx.doi.org/10.1177/036354659602400606] [PMID: 8947393]
[31]
Kim YC, Chung IH, Yoo WK, Suh JS, Kim SJ, Park CI. Anatomy and magnetic resonance imaging of the posterolateral structures of the knee. Clin Anat 1997; 10(6): 397-404.
[http://dx.doi.org/10.1002/(SICI)1098-2353(1997)10:6<397::AID-CA5>3.0.CO;2-M] [PMID: 9358970]
[32]
Iida H, Arisawa O, Yufu J. A case of peroneal nerve palsy compression by the fabella. Orthop Surg 1976; 27: 299-302.

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